We recently said good-bye to Patricia, a traveling Certified Nursing Assistant who has worked at a number of locations across the country. Her outgoing personality, warmth, and compassion made it easy for staff and residents to connect with her on a very personal level. We loved having her as a member of Team Valley VNA for 12 weeks and we wish her every success! Patricia shared a few thoughts with us:
Dear Valley VNA,
My stay at your facility was one of my greatest experiences. My twelve 12-week assignment was memories in the making. I worked alongside my darling Andrea. She helped me a lot, and was very knowledgeable and able to guide me on the Sapphire routine.
I totally felt deep care for all the residents, most of all: Sue S, Sue D, Queen Ruth, Mary V, Mary Jane, Carol P, Carol Z, Ollie, Erma P, Uncle Peter, Jack, Dale, Bill, Thomas, Ellie, James, Frances, Beverly, Jean A, Janice, Donna, and Lorraine.
Valley VNA was one of my best assignments, and the very first place I have ever seen the administrator (Angela) not afraid to get her hands dirty, and the CEO (Theresa), was always picking up shifts.
These are the VNA team members that made my stay a success:
Ms. Crystal and Ms. Pat, Jessica Sakis, Jessica the bingo lady, All Lead Shift Managers: Corey, Kellie, Joelin, Nichole. Caregivers: Amber, Nicole, Danielle, Kara, Ruth, Eliza, Grace, Amanda, Ms. Carol, Rose, Becki, Comfort, Josia, Lynn, Tiffany, Raiza, Britney, Alisa.
And, Stacy Hole (one of the kindest people I’ve ever met), Maria, Elijah, Carter, Mama Myrna, Julie, Maria (the hairnet lady), Carrie (the soup lady), the maintenance team, Jimmy and Karen. The housekeeping team: Latrice, Elissa, night crew, the two sisters.
And, one of my favorite ladies is Christy (the piano lady).

By Theresa Pichelmeyer, EdD, RN, President and CEO of Valley VNA Senior Care

National Health Care Decisions Day is April 16, a day set aside to educate and empower people and their family members about the importance of advance care planning. The Power of Attorney for Health Care, or POA-HC, is a document that any adult, age 18+ (the “principal”) completes and signs, naming another individual (the “agent”) to make one’s health care decisions when the principal might become unable to make those decisions for him or herself.

Most people never plan on becoming incapacitated. Many think a POA-HC is just for old people. However, every adult should think about a few situations where they, at any age, might need a POA-HC: a car, ATV, or snowmobile accident that leaves you in a coma; a prolonged bad reaction to a drug; an injury sustained in a violent crime; or a life-threatening event, like a stroke or progressive disease. Therefore, all adults, or a loved one who is becoming an adult, needs a POA-HC.

There are several important reasons why every adult, age 18 or older, should complete a POA-HC. The “next of kin” idea simply does not apply in modern times. In Wisconsin, a family member is not automatically authorized to make health care decisions for an adult relative unless he or she completes a POA-HC document naming that person as one’s agent. Secondly, it’s not just about end-of-life care. Hopefully the sick or injured person will recover from his or her health crisis. The POA-HC is about receiving the care one needs and wants when he or she can’t speak for oneself. Also, a person’s family may have to go to court to appoint a guardian without a POA-HC in place. This process can be costly, time-consuming, cumbersome, and emotionally draining.  And then, a court-appointed guardian may not be the person the principal would have chosen. The appointed person may have no idea of the person’s wishes or what care he or she might or might not want.

Every adult should choose his or her agent carefully. A person’s health care agent, upon being activated, might make some very important decisions regarding choosing a doctor, treating a medical condition, managing pain, maintaining or refusing artificial hydration and nutrition, and consenting to or refusing surgery. Principals should be confident that their agent will follow their wishes. An agent should be able to resist pressure to influence a person’s choices from friends and family. Nor should the agent make decisions about a person’s care according to his or her own ideas. An agent should be capable of dealing with hospitals, doctors, and stressful health care situations and understand the choices surrounding the principal’s particular injury or condition. A health care agent should be assertive. He or she should be able to ensure that the principal is being treated properly and insist on full, open, and transparent communication with his or her care providers. A chosen health care agent should live nearby or be willing to travel if needed.

To be deemed incapacitated, two physicians must personally examine you and certify that a person can no longer receive, evaluate, and communicate his or her health care wishes. All adults should rest assured, despite creating the document, they keep their right to make their health care decisions as long as they are able. They can also update their POA-HC at any time to change their agent or add specific instructions. If a POA-HC is activated and a person regains his or her ability to make health care decisions, the POA-HC can be rescinded.

How to Prepare and Submit a POA-HC

  • Download the POA-HC form from the Fox Valley Advance Care Planning Partnership website. You will need witnesses to your signature, but you do not need a lawyer’s or notary public’s s
  • Take time to discuss your wishes. Don’t just fill out the form. The POA-HC is only as good as the effort you put into thinking about your own wishes and communicating them to your agent.
  • Talk with your entire family about your wishes. When everyone is on the same page, it prevents family discord in the future. In a chaotic and emotional time, your pre-planning will provide an element of peace.
  • Hand deliver your completed POA-HC to your doctor’s office or mail or fax it to your health system’s medical records office. Keep a copy for yourself and send one to your health care agent.
  • In Neenah, Valley VNA Senior Care helps people of any age complete their POA-HC and can help with questions regarding Advance Directives. Call to set an appointment at 920-727-5555.

Theresa Pichelmeyer, EdD, RN, President & CEO

Valley VNA Senior Care

 

In January 2022, Valley VNA will turn 114! We are proud of our steadfast commitment to the health and happiness of older adults in our community and their families.

Steadfast means resolutely or dutifully firm and unwavering; the resolve not to be persuaded or worn down to be something we are not. When I set foot inside Valley VNA each new day, these are some of the things I see, hear, and experience. These things are infused with loyalty, commitment, and devotion to the people and culture of Valley VNA. Put another way, they really show what we stand for:

On December 9, the community of Valley VNA celebrated 30 years of Love Light Angels, the opportunity for residents, families, and community members to dedicate an ornament on our Love Light Angels tree in honor of someone special. Three decades in, and our community remains steadfast in support of Valley VNA’s special Christmas tribute.

Valley VNA volunteers are some of the kindest people I know. They remain committed to safely engaging with our clients and residents, from spiritual companionship to rickshaw rides (during the biking season) and other opportunities like gardening or reading. We are especially proud of Valley VNA volunteers who discover the passion we have for our vocation. In fact, two of them of them recently accepted employment at Valley VNA, and we couldn’t be happier:

  • Tom Lyons, husband to kind and musical Carol who lived with us before her death in 2020, is also known to all of us as a generous and skillful rickshaw pilot and facilitator of our men’s caregiver support group. Tom has begun caregiver training to become a member of our direct-caregiving staff at Valley VNA.
  • Kristi Branchford, also known to Valley VNA as a rickshaw pilot and supportive volunteer, has joined our staff as the new Valley VNA Senior Living Advisor. She takes up a key position to introduce potential new residents and families to Valley VNA.

When there is a call for more hands on deck, especially during this difficult era that combines pandemic precautions and staffing challenges across the health care field, our existing team members consistently step up. I see staff members pitching in to fill open shifts to support one another—and the residents and families we serve.

Many of our community programs are up and running, from Foot Care Clinics to Respite Care Programs and Meals on Wheels. As humans, we know that the need for health and social connections do not dissipate during difficult times—they become more important than ever.

Thank you for your steadfast support of Valley VNA. As we strive to serve, you consistently respond with kind words, staff treats, and support for our mission.  Happy holidays and best wishes for a good 2022—Valley VNA’s 114th year! Know that the people of Valley VNA remain steadfast in our commitment to our community and those we serve.

By Cami Tesch, Student Nurse

College of Nursing, University of Wisconsin Oshkosh

 

Alzheimer’s and Dementia

Alzheimer’s and dementia are often used interchangeably. However, think of dementia as a big umbrella with categories underneath it. Alzheimer’s is one of those categories. Dementia is characterized by memory decline, while Alzheimer’s is decreased cognitive ability caused by increased plaques and cell death in the brain.

It was reported that in 2020, 120,000 cases of Alzheimer’s were diagnosed in Wisconsin. There is early onset Alzheimer’s, but the older adult population (65+) is the most common age group to be diagnosed. It is also more common in women rather than men.

How do I know if my loved one is experiencing Alzheimer’s or just common aging characteristics?

There are characteristics of aging that could be mistaken for Alzheimer’s. For example, a common characteristic of aging may be to forget where an object is placed, but remember a couple of hours later. A characteristic of Alzheimer’s is placing an object in the completely wrong place, such as milk in the cupboard instead of the fridge, and not remembering it. Another characteristic of Alzheimer’s would be confusion over a simple conversation. Alzheimer’s tends to progress through stages to where, eventually, a person cannot remember or perform typical daily activities.

What are the stages of Alzheimer’s?

Stage 1: Early Stage (Mild)

In the beginning stage, individuals may still be continuing on with their daily lives. They, along with those close to them, may be noticing slight delays in their memory. It isn’t a huge change but there are some instances such as misplacing an object used daily, getting slightly confused in a conversation, and forgetting a few names here and there.

Stage 2: Middle Stage (Moderate)

This is typically the longest stage in patients with Alzheimer’s. This stage is more prominent to those around the individual. The patient is becoming more forgetful and confused. You may find your loved one wandering around. They may get lost in the house trying to find a specific room. Incontinence or having accidents may become more common. Someone at this stage may need to be watched a little more carefully.

Stage 3: Late Stage (Severe)

This is the last stage of Alzheimer’s progression. While in this stage, the individual will need constant care. They will most likely need to be fed, need total assistance when using the bathroom, and need partial or total help with all daily activities. Confusion is at its peak, there is an increased risk for falls and wandering.

Is there a cure for Alzheimer’s?

Unfortunately, there is no cure for Alzheimer’s, but there are many treatments to help with memory decline and behavior. A physician may be able to prescribe medications for memory decline, mood, sleep disturbances and behavior. There are medications to help, but it is still very important to make some lifestyle changes. For example:

  • Keep the same bed time every night.
  • Do not eat dinner right before bed.
  • Make sure the environment is calming and a comfortable temperature.

Caregiver Burnout

Caring for a loved one on a daily basis puts a lot of stress on the caregiver and their relationships. Respite care can be an amazing resource for caregivers to take times for themselves. There are many care resources within the community that want to help, which will help not only you, but also your relationship with your loved one.

 

All links below provide excellent resources on facts of Alzheimer’s and support programs:

https://www.alz.org/alzheimer_s_dementia

https://www.dhs.wisconsin.gov/aging/caregiver.htm

References:

Wisconsin family caregiver support programs. (2021). Wisconsin Department of Health Services. Retrieved from: https://www.dhs.wisconsin.gov/aging/caregiver.htm

Alzheimer’s and dementia. (2021). Alzheimer’s Association. Retrieved from: https://www.alz.org/alzheimer_s_dementia

Normal ageing vs dementia. (2021). Alzheimer’s Society. Retrieved from: https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/normal-ageing-vs-dementia

By Cami Tesch, Student Nurse

College of Nursing, University of Wisconsin Oshkosh

 

What is Congestive Heart Failure?

Congestive heart failure is when the heart is not able to pump a sufficient amount of blood through the body. The left side of the heart is responsible for pumping oxygenated blood to the body. When someone has heart failure, fluids begin to pool and back flow to the lungs, causing the congestive portion. The right side of the heart is responsible for pumping blood from the body to the lungs. If the lungs are already backed up, there is going to be a back flow to the rest of the body.

If there is a back flow of fluids into the lungs, a person may be having symptoms such as a productive cough with tinted mucus, and shortness of breath or wheezing. A main sign of right sided heart failure is edema in the lower legs, ankles, and feet. Edema is when there is a substantial amount of fluid pooling in a certain area. It may or may not become painful. Because there is a lot of fluid pooling in the lower extremities and not going back to the heart, becoming very dizzy when standing up from a seated position is common.

Is there a way to prevent Congestive Heart Failure?

There are several ways to help prevent heart failure. One important thing to remember is to eat healthy which includes a low sodium diet. Keeping sodium intake low helps to decrease any retention of fluids. Reducing fat intake is also important in the prevention of heart failure. Exercise is a good way to keep weight at a healthy level. A main factor associated with heart failure is high blood pressure. Smoking increases blood pressure, which is why quitting smoking is a way to help prevent heart failure.

How can medical professionals tell if I have heart failure?

There are several tests that can be conducted if someone is suspected of having heart failure. One test is an EKG, or electrocardiogram, which includes putting several electrodes over the chest to see how the heart is beating. Another test, called an echocardiogram, is an ultrasound of the heart. This allows medical professionals to see if heart muscles and valves are working properly and if they are pumping the sufficient amount of blood. More information can be found here.

What is the next step?

If someone is diagnosed with heart failure, the doctor may prescribe some form of medication(s). Some of these may include antihypertensives, diuretics, or blood thinners. Each case of heart failure may be different. There are several different ways to begin treatment, so be sure to talk with a doctor about any concerns.

References:

Cleveland Clinic Medical Professional. (2021). Heart failure. Cleveland Clinic. Retrieved from: https://my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heart-failure

Healthwise Staff. (2020). Right-sided heart failure. Frankel Cardiovascular Center: University of Michigan Health. Retrieved from: https://www.umcvc.org/health-library/tx4093abc

John’s Hopkins Researchers. (2021). Congestive heart failure: prevention, treatment and research. John’s Hopkins Medicine. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/congestive-heart-failure-prevention-treatment-and-research

By Cami Tesch, Student Nurse

College of Nursing, University of Wisconsin Oshkosh

Unravelling the stigma of depression

Depression isn’t something that you can get over with the snap of your fingers. The condition is a chemical imbalance in the brain. The three main chemicals that are deficient are serotonin, dopamine and norepinephrine, or, the happy hormones. It can be just the way the body is wired, and every single person is different. So, a person isn’t to blame if they are diagnosed. What a lot of people don’t know is there is a high rate of depression in the older adult population. Many people mistake depression for a common aging characteristic, but it’s not. Some people may have a slight decrease in energy, but depression is not a natural part of aging, and there is much a person can do to battle depression.

Is sadness the only symptom of depression?

One symptom of depression is decreased mood, and there are many more, including:

  • Loss of interest in things that gave you joy in the past
  • Decreased energy
  • Loss of appetite
  • Weight loss
  • Sleep disturbances
  • Emotional outbursts on a frequent basis
  • Isolating yourself from others
  • Thoughts of harming yourself
  • Irritability

Is medication necessary for depression?

Even though there are several medications to help with depression, there are additional strategies that can help:

  • Exercise more to release endorphins that elevate mood.
  • Change diet to include more lean meats, fruits and vegetables to keep energized.
  • A consistent sleep routine helps with sleep disturbances.
  • Talk with someone: a family member, friend, or certified counselor.

The great thing about working with a certified counselor today is there are many ways to have your sessions. If you are not comfortable going into a facility, there are options to have a video chat session. You can have a counselling session in the comfort of your own home and may even feel more comfortable to share information.

 

Substance abuse and mental health services administration: 1-800-662-HELP (4357)

This helpline is 100% free and confidential. You can call any time, day or night. https://www.samhsa.gov/find-help/national-helpline

For more information on depression:

https://www.psychiatry.org/patients-families/depression/what-is-depression

References:

National helpline. (2021). Substance abuse and mental health services administration. Retrieved from:

https://www.samhsa.gov/find-help/national-helpline

Torres, F. (2020). What is depression. American Psychiatric Association. Retrieved from:

https://www.psychiatry.org/patients-families/depression/what-is-depression